Your Eating Disorders Need-to-Know Guide

Featured Article, Growth and Development, Health and Safety

“I remember that it was around first grade the first time I purposely didn’t eat when I was hungry,” Andi Craven of Hendersonville, NC, recalls. “By that time, it was about a year after I began being sexually abused and it would be two more years that the abuse continued.”

When she was 11, Andi’s older brother attempted suicide, further straining family dynamics already handicapped by a mother struggling with her own undiagnosed mental illness.

By the time Andi was 14, not eating was the routine. Her hair began falling out from malnutrition and she was wearing her brother’s baggy clothing in an effort to hide the extent of her diminishing frame.  “I didn’t break 100 pounds until I was 18 years old,” she says.

Hiding, however, proved to be unnecessary.

“I was, basically, invisible. As long as my brother wasn’t dead, nobody cared what was happening with me.”

These days, the 30-year-old social worker and mother of two says her childhood experiences have shown her just how important it is, as a parent, to be diligent about really paying attention to changes in her own children’s behavior.  Although she says that she has gotten “much better” in her adult years, she still struggles with lingering mental and physical effects of her younger days. Had her parents sought early treatment for her, she believes, she would have had a better shot at a full recovery.

“I want (my children) to feel like no matter what is going on in my world, they matter and they are loved,” Andi says. “It’s not about how they make us look as parents. Being a mom, especially, made me realize that my parents should have known. I was just a kid, so I didn’t even have a name for what was going on with me, let alone a solution.”

It is estimated that 24 million people in the United States struggle with an eating disorder. According to the National Institute of Mental Health, 2.7 percent of teens ages to 13-18 are included among these.  Of those, 0.3 percent are affected by anorexia, 0.9 percent by bulimia and 1.6 percent by binge eating disorder.  No race, gender or socio-economic group is exempt. While the causes vary widely from trauma and bullying to peer and media pressures to be thin, the treatments all begin with the same step: Identifying the affected child.

What to Look For

In today’s weight-conscious society when so many are trying the latest diet or weight-loss fad, it can be difficult to determine when a teen has crossed over into the arena of a full-blown eating disorder. Here are a few things experts agree can be red flags:

• Eating in secret or resisting sitting with the rest of the family for meals

If your child consistently makes excuses such as “I already ate” or “I have a stomachache” to avoid joining the family during mealtime, or if she is hiding or hoarding food, there could be a problem.  They could be not eating much, if at all (anorexia nervosa) or are ashamed of the amount they are eating. (bulimia or binge eating disorder). “It’s like I became desperate to be hungry,” Andi recalls. “Not eating was a kind of euphoria for me so I would do whatever it took to not eat.”

• Constant or frequent dieting

Although we often hear about the epidemic of childhood obesity these days, the truth is that the majority of teens do not need a restrictive diet. A developing child who limits food intake to control weight could be causing harm to their growing bodies. Besides, research shows that it often doesn’t work and can even potentially cause weight gain and lead to further disordered eating habits later in life.

• A preoccupation with food

It’s OK if your teen checks food labels and packaging in efforts to eat healthy, vitamin-rich foods, but if she is constantly talking about how “fatty” certain foods are or how many calories she has consumed or needs to “burn off,” pay close attention. Food phobias or avoidance of certain foods should also be concerns.

• Hiding her body

For Andi, ditching fitted clothing for her brother’s baggier wardrobe was one way to hide just how small she had become.  It also could be a sign that your teen sees herself as overweight or “fat” even though she is clearly underweight. This is known as “Body Dysmorphic Disorder (BDD),” a distorted body image seen in some eating disorders.

• Skipped periods

An occasionally missed period by a teen that has begun menstruating isn’t cause for alarm. However, if you notice that she is missing several in a row or has stopped asking you to purchase feminine products, be aware that there could be a problem.  Of course, consult with her physician to rule out any other medical conditions that could be the cause.

• Compulsive exercising

That is, exercising several times daily, particularly if your teen indicates the need to “work off” what she has eaten. Excessive preoccupation with burned calories, lost inches or weight, etc., can indicate an issue.

• Perfectionism

Pay close attention to your teen’s hyper-emphasis on excelling in school, sports or other activities. “It was all about control,” Andi says of her obsessive need for perfection, particularly as a lifelong dancer. “I was very regimented; everything had to be a certain way. The mentality that I had was, ‘Either you’re fat or skinny, right or wrong.’ Everything was black or white. Nothing was gray, and it all had to be just right.”

• Changes in appearance

Is your teen losing or gaining lots of weight in a relatively short amount or time? Do her hair, skin and teeth appear weaker or off-color? If so, you could be witnessing the effects of malnutrition.  Hair loss, ashen or yellow skin tone and yellowed, decaying teeth are other signs to look for.  And keep in mind that everyone with an eating disorder isn’t thin. Some are even overweight, as is often the case with binge eating disorder.

If You Suspect Your Teen Has a Disorder

If you suspect a problem, whatever you do, do something. Burying your head in the sand not only will not work, its consequences could prove deadly. Eating disorders are life-threatening and should be identified and treated as early as possible to achieve full recovery. In fact, anorexia has the highest mortality rate of any mental disorder, at up to 20 percent. Research shows that if left untreated or if treatment is delayed, eating disorders during adolescence often continue to manifest well into adulthood, potentially damaging the brain, heart, bones, kidneys and liver.

If your teen exhibits one or more of the signs included in this article, it is important to seek the care of a comprehensive eating disorder treatment program sooner rather than later. This usually includes a physician, a psychologist or therapist, a psychiatrist, a dietician and a physical therapist. The goal is to help your child achieve and maintain a healthy weight by reversing the physical damage and treating the underlying psychological causes.

There are many organizations available to help. The National Eating Disorder Association is one of several working to prevent eating disorders, eliminate body dissatisfaction and provide treatment referrals.  They can be reached through their Information and Referral HelpLine at 800-931-2237.

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